| NPI | 1013275775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE M GORDEN Administrator 414-217-2495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |